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NYU Researchers Win $2.9 Million NIH Grant to Study Developmental Pathways of Young Gay Men

May 18, 2009
N-469, 2008-09

Although strides have been made in the fight against HIV and AIDS in recent years, infection rates continue to climb for certain populations. Last year, the New York Department of Health and Mental Hygiene reported that among young males between 13 and 29, rates of HIV infection increased by 9 percent. Seventy-five percent of these cases involved men who have sex with men (MSM).

Hoping to better understand the developmental pathways of this population of young MSM and the specific risk factors for HIV infection, researchers at the Center for Health, Identity, Behavior, and Prevention Studies (CHIBPS) at New York University are embarking on a three-year longitudinal study of the behavioral choices of young MSM. The $2.9 million study is funded by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health. The research grant will be administered through NYUs Institute of Human Development and Social Change.

According to Perry Halkitis, director of CHIBPS and professor of applied psychology and public health at NYU Steinhardt, emergent adulthood is a period of time when young gay men are highly vulnerable not only to HIV infection but also to hepatitis B and C, syphilis, gonorrhea, and drug use. He adds, Young gay men may be more at risk in part due to the stigma and discrimination that they face.

The study, called P18 (Project 18, both because of the age cohort and because this is the 18th project at CHIBPS), will examine the synergy that exists between sexual risk-taking, mental health, and drug use among a cohort of 675 18-year old MSM. The research is built on the theory of syndemics, says Halkitis. Syndemic theory suggests that risk-taking, drug use, and mental health burden are socially produced ills that create vulnerability to disease.

In order to understand the vulnerability of young MSM to these epidemics, Halkitis and his team want to understand young mens developmental trajectories. The behavioral literature almost always focuses on problematic or maladaptive behaviors. We hope to document the adaptive behaviors and pathways and help community agencies develop programs based on those adaptive patterns, Halkitis explains.

Halkitiss team will track 675 young men for three years. Moreover, the sample will be stratified by race, ethnicity, and socioeconomic status (SES). Our goal is to dispel the mythologies that all men within a particular racial group function in the same way, says Halkitis. We aim to show that race and racial identification interact with SES, with family and social dynamics, and within social contexts to help to explain behaviors.

Data will be collected every six months on such aspects as sexual behavior, drug use, peer and romantic relationships, and mental health, as well as adaptive behaviors such as civic engagement, employment, schooling, friendships, and involvement in loving relationships. In addition, the subjects will be tested for HIV at the onset of the study and every six months and will be randomly tested for drug use. Subjects with preliminary positive HIV results will be referred to the NYU School of Medicine for treatment and will be offered psychological counseling through the CHIBPSs community partners, including the LGBT Community Center of New York City.

By using a set of sophisticated data collection tools, including computer administered mental health surveys, assessments of executive functions, and biological assays such as HIV antibody tests and drug urine toxicology, Halkitis and his researchers will be able to follow the behavioral patterns of their subjects with great precision. Data from the sample, for instance, will show the degree to which sexual risk taking changes with drug use.

Were trying to delineate the factors which predispose young men to develop along pathways that lead to risk, reduce risk, and/or eliminate risk, he says. What appears clear from decades worth of research conducted by CHIBPS is that mental health burden, drug use, and sexual risk-taking function synergistically. What is unclear is what the pathway are that lead to the development of the syndemic.

A central piece of the work is also to examine the role of context or place and to determine how residential, social, and sexual neighborhoods help to explain the development of young MSM.

Noting that HIV infection disproportionately affects young men of color, Halkitis aims for men of color to represent approximately 80 percent of his sample.

Our hypothesis is that SES interacts with race to affect sexual risk-taking. He and his team hope that the P18 study will reveal the psychological burdens young MSM - especially young men of color-face, with an eye towards crafting prevention messages that work for this vulnerable group. He also believes that that, by incorporating a biopsychosocial perspective, the work will understand the total experience of young mens lives, rather than simply treat gay men as a vessel for transmitting HIV.